EP1876967A2 - Dispositif de suture de plaies et d'hemostase dans la paroi thoracique ou abdominale, principalement au cours d'operations endoscopiques - Google Patents

Dispositif de suture de plaies et d'hemostase dans la paroi thoracique ou abdominale, principalement au cours d'operations endoscopiques

Info

Publication number
EP1876967A2
EP1876967A2 EP06728234A EP06728234A EP1876967A2 EP 1876967 A2 EP1876967 A2 EP 1876967A2 EP 06728234 A EP06728234 A EP 06728234A EP 06728234 A EP06728234 A EP 06728234A EP 1876967 A2 EP1876967 A2 EP 1876967A2
Authority
EP
European Patent Office
Prior art keywords
wound
thread
wall
port
trajectories
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP06728234A
Other languages
German (de)
English (en)
Inventor
Vladimir Shpaichler
Evgeny Shpaichler
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP1876967A2 publication Critical patent/EP1876967A2/fr
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0482—Needle or suture guides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas

Definitions

  • the present invention relates to the field of medicine and veterinary medicine and, more particularly, to devices for wound suturing and hemostasis in endoscopic, mainly, laparoscopic and thoracoscopic, operations.
  • the invention may as well be used for suturing wounds of any etiology similar to those formed during the endoscopic operations.
  • an endoscopic operation comprises the following steps:
  • the other principle involves the use of special devices diminishing the traumatizing effect of wound suturing and reducing labor expenditures.
  • a device for wound suturing in laparoscopic operations was used until recently comprising a tubular body with a suturing unit built therein and including two needles with threads parallel to the longitudinal axis of the body.
  • the needles move apart.
  • the tubular body together with the suturing unit is drawn upwards and the abdominal wall is pierced by the said parallel needles.
  • the tubular body is to be inserted into the cavity again and the suturing unit is to be returned into the tubular body.
  • the use of this device reduces the traumatizing effect but layer approximation remains significantly disarranged because of the parallel motion of the threads through a thick tissue sutured.
  • the device comprises a cone-shaped member having a pair of guides for two thread-grasping members, or graspers, functioning jointly during the said wound suturing.
  • the guides are oriented in such a manner that when the cone-shaped member is in the wound channel they determine such trajectories of motion of the thread- grasping members that the thread-grasping members are inserted through the abdominal wall into zones containing preset points.
  • the cone-shaped member is inserted with its apex into the wound channel when the port is removed. Then the graspers are inserted into the preset points through the guides in the cone-shaped member.
  • this device reduces the traumatizing effect during wound suturing but even in this case the wound remains an unstable layer structure, so the approximation of layers of the abdominal wall is disarranged during wound suturing, as described above. This is accounted for, primarily, by the circumstance that the wound surface contacts that of the cone-shaped member only partially.
  • the search for the wound channel with the cone apex is often difficult and may cause a change in the wound configuration and a further disarrangement of its layer structure.
  • the object of the present invention is, therefore, the task of developing a device for wound suturing and hemostasis in endoscopic operations that would allow to preserve the initial shape of the wound channel and the stable layer structure of the wound by the moment of suturing to diminish the probability of post-surgery complications, and as well would ensure the initially correct directions of motion of the thread- guiding members inserted through the abdominal or the thoracic wall into the pre-specified points of the body to diminish the traumatizing effect of wound suturing and to reduce labor and time expenditures connected therewith.
  • the device comprises a body having a tubular wall, its outer cross-sectional perimeter matching the cross- sectional perimeter of the pre-specified wound channel and its length exceeding the preset length of the wound channel.
  • the guides are fixed on the body and oriented so as to ensure such trajectories of motion of the thread-guiding members that the threads guided by them are lead into the pre-specified points of the body through the abdominal or the thoracic wall.
  • Fig. 1 shows the general view of the device of the present invention.
  • Fig. 2 shows the general view of the device in its operating position.
  • Fig. 3 is a view along arrow A in Fig. 2.
  • Fig. 4 shows the general view of the device in its operating position when used for another purpose.
  • Fig. 5 is a view along arrow B in Fig. 4.
  • the proposed device for wound suturing and hemostasis is used after endoscopic operations wherein a port is employed.
  • the device comprises body 2 (Fig. 1) having cylindrical tubular wall 4 equipped with capping 6 on one end thereof and intended for preservation of the initial shape of wound channel 8 (Fig. 2,3) during the entire operation.
  • Embodiments of the present invention are possible wherein the tubular wall has other than the cylindrical shape.
  • Outer side 4a of wall 4 in its shape and size matches the preset shape and size of wound channel 8.
  • wound channel 8 size denotes the length of the cross-sectional perimeter of the wound channel wall.
  • size matching we mean the equivalence of sizes with acceptable deviations small enough to allow the fulfillment of the object of the present invention and easy to find experknentally.
  • shape of our devise in cross section may be different from the • wound chanell shape in cross section. For example it may be star- shaped. In such a case the shape of the body wall will be chosen in order to preserve the stable layer structure of the wound.
  • Inner side 4b of wall 4 has a diameter making it possible for port 10 to be moved inside wall 4 along its longitudinal axis 12.
  • paired guides 14 are provided, made in the shape of slots and intended to guide thread-guiding members 16, predominantly, needles. Guides 14a, 14b of each pair are symmetrical relative to axis 12.
  • Guides 14 are oriented so that when port 10 is in its operating position they ensure such trajectories of motion of thread-guiding members 16 (Fig. 2,3) that the threads guided by them are lead into the pre-specified points "a" and "b" of abdominal or thoracic cavity 18 through abdominal or thoracic wall 20, respectively.
  • the operating position of the port such position is meant whereby tubular wall 4 is inserted into the wound channel throughout the length of the latter.
  • the number of guides 14 and their orientation are determined by the specific purpose of the device (wound suturing, hemostasis or the both). The areas of tubular ,.
  • wall 4 located in zone "c" of trajectories 22 of motion of thread- guiding members 16 are made of a material that may be pierced through by these thread-guiding members, for example, of silicon. Such an arrangement does not require the modification of the design of the existing ports.
  • the proposed device is operated as follows.
  • the port 10 Before the beginning of an endoscopic operation the port 10 is inserted into tubular wall 4 of body 2 and is fixed therein by any of known methods, for example, by means of a threaded connection (not shown for considerations of simplicity). Then tubular wall 4 together with port 10 is inserted through abdominal or thoracic wall 20 into abdominal or thoracic cavity 18, respectively. Thereby a wound - wound channel 8 - is formed in wall 20. After that, a surgical or a diagnostic instrument (not shown) is inserted into cavity 18 through the inner cavity of port 10, a surgical or a diagnostic manipulation is performed, and the instrument is removed. Then port 10 is detached from body 2 and removed therefrom whereas tubular wall 4 stays in wound channel 8 providing for a reliable preservation of the initial shape of wound channel 8 and for the stability of the wound layer structure.
  • the device is used separately from the port.
  • the port is inserted into cavity 18 without the proposed device.
  • a guide (not shown) is passed through the port whereupon the latter is removed.
  • the guide staying in the wound channel makes it possible to preseive the stable layer structure of the wound.
  • the device of the present invention is then inserted into the wound along the guide. This arrangement, too, does not involve the modification of the design of the existing ports, and, moreover, it is more universal as it allows to employ the same device in different wound channels with comparable cross-sectional sizes.
  • First thread-guiding member 16 together with (suturing) thread 24 is moved along guide 14a ensuring trajectory 22, to be inserted into preset point "a" of cavity 18, and successively pierces through zone “c" of tubular wall 4, and wall 20.
  • second thread-guiding member 16 with graspers (not shown) is inserted into point "b” in a similar manner, the said graspers grasping thread 24 to guide it out of the cavity along the same trajectory.
  • the device for wound suturing is removed from wound channel 8 and thread 24 is tied forming a suture.
  • a second suture may be made with the help of a second pair of guides 14, when necessary.
  • the suture may cut the central axis of the wound channel or lie beyond it.
  • guides 14 are oriented so that point "d" of intersection of trajectories 22 lies on longitudinal axis 12 (Fig. 2, 3). Such positioning of the suture is optimal for tightening the wound itself.
  • guides 14 are oriented so that point "d" of intersection of trajectories 22 lies beyond longitudinal axis 12 (Fig. 4, 5).
  • Such suture is used, for example, to suppress a marginal bleeding.
  • port 10 may be used in the capacity of the body, or his part, of the proposed device.
  • the port itself or to the mentioned additional part of bodyjhas guides 14 and said zones "c" may be made of a material to be pierced through by thread-guiding members 16. This arrangement, however, may requires modifications to the design of the port.
  • port 10 stays in wound channel 8 ensuring the reliable preservation of the initial shape of wound channel 8 and the stable layer structure of the wound. Suturing is performed as described above.
  • outer side 4a of wall 4 may have a shape other than the preset shape of the wound channel. Its cross section may be shaped as an ellipse, a. triangle, etc. In this case it is sensible to insert the proposed device into the wound channel with the help of the said guide.
  • the use of the device of the present invention allows - due to the reliable preservation of the initial shape of the wound channel and of the stable layer structure of the wound, as well as to the possibility of making a strictly directed suture - to considerably red ⁇ ce the disarrangement of approximation of layers of the abdominal or the thoracic wall, and, hence, to diminish the risk of post-surgical complications such as bleedings, suppurations and hernias.
  • the use of the proposed device eliininates the time-consuming step of search for the wound channel after the port is removed which facilitates considerably wound suturing after an operation.
  • the device of the present invention may also be used to fix various tissues and materials inside the abdominal, the thoracic or other cavity.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Surgical Instruments (AREA)
  • Endoscopes (AREA)

Abstract

Le dispositif de l'invention a pour objet de réaliser une fermeture complète directe et surveillée de la plaie au site d'accès, ce qui induit simultanément les avantages suivants: 1) la préservation de la forme initiale du canal de la plaie; 2) la préservation de la stabilité de la structure en couches de la plaie au site d'accès pendant la suture; 3) l'insertion précise, surveillée, semi-automatique des éléments de guide-fils.
EP06728234A 2005-04-19 2006-04-06 Dispositif de suture de plaies et d'hemostase dans la paroi thoracique ou abdominale, principalement au cours d'operations endoscopiques Withdrawn EP1876967A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IL16812905 2005-04-19
PCT/IL2006/000433 WO2006111955A2 (fr) 2005-04-19 2006-04-06 Dispositif de suture de plaies et d'hemostase dans la paroi thoracique ou abdominale, principalement au cours d'operations endoscopiques

Publications (1)

Publication Number Publication Date
EP1876967A2 true EP1876967A2 (fr) 2008-01-16

Family

ID=37115553

Family Applications (1)

Application Number Title Priority Date Filing Date
EP06728234A Withdrawn EP1876967A2 (fr) 2005-04-19 2006-04-06 Dispositif de suture de plaies et d'hemostase dans la paroi thoracique ou abdominale, principalement au cours d'operations endoscopiques

Country Status (3)

Country Link
US (1) US20080097485A1 (fr)
EP (1) EP1876967A2 (fr)
WO (1) WO2006111955A2 (fr)

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EP2349021A4 (fr) * 2008-07-02 2017-03-22 A.H. Beeley Pty Ltd Appareil et procédé de suture de site d'ouverture laparoscopique
GB2486497B (en) * 2010-12-17 2013-06-19 Neosurgical Ltd Laparoscopic trocar system
US9855031B2 (en) 2010-04-13 2018-01-02 Neosurgical Limited Suture delivery system
US10420585B2 (en) 2011-02-16 2019-09-24 Reza Mohajer-Shojaee Laparoscopic cannula with suturing passage cutoff
US9033872B2 (en) * 2011-02-16 2015-05-19 Reza Mohajer-Shojaee Laparoscopic cannula with suturing capability
US20130035702A1 (en) * 2011-08-04 2013-02-07 Suture Ease, LLC Dual insufflation and wound closure devices and methods
US8979747B2 (en) 2011-09-23 2015-03-17 Cooper Surgicalk, Inc. Endoscopic ports and related kits and methods
GB2495534B (en) * 2011-10-13 2014-04-23 Neosurgical Ltd Laparoscopic system
GB2496658A (en) * 2011-11-18 2013-05-22 Neosurgical Ltd Surgical closure device
EP2797519B1 (fr) 2011-12-27 2023-05-31 CooperSurgical, Inc. Guides d'instruments de passage de suture et kits
US9393011B2 (en) 2012-03-13 2016-07-19 Suture Ease, Inc. Needle and snare guide apparatus for passing suture
US9066717B2 (en) 2012-05-18 2015-06-30 Coopersurgical, Inc. Suture passer guides and related kits and methods
WO2014017706A1 (fr) * 2012-07-27 2014-01-30 가톨릭대학교 산학협력단 Trocart pour chirurgie laparoscopique
US9271721B2 (en) * 2012-12-19 2016-03-01 Cook Medical Technologies Llc Port closure device
CN103230303B (zh) * 2013-03-24 2015-05-27 鞠文龙 腹腔镜穿刺器固定装置
US10426472B2 (en) 2013-08-02 2019-10-01 Covidien Lp Devices, systems, and methods for wound closure
US9510823B2 (en) 2013-08-02 2016-12-06 Covidien Lp Devices, systems, and methods for wound closure
US10201346B2 (en) * 2013-08-02 2019-02-12 Covidien Lp Devices, systems, and methods for providing surgical access and facilitating closure of surgical access openings
KR200473904Y1 (ko) 2013-12-02 2014-08-08 가톨릭대학교 산학협력단 복강경 수술용 투관침
US10299785B2 (en) 2016-04-01 2019-05-28 Ethicon Llc Surgical access devices with integrated wound closure features
KR102026748B1 (ko) * 2017-08-11 2019-09-30 김기성 봉합기능을 갖는 복강경 수술용 투관침
WO2019092474A1 (fr) * 2017-11-07 2019-05-16 Thd S.P.A. Ensemble de guidage de suture
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Also Published As

Publication number Publication date
US20080097485A1 (en) 2008-04-24
WO2006111955A2 (fr) 2006-10-26
WO2006111955A3 (fr) 2007-09-27

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